When you come for a check up, you’ll probably wonder what the numbers are that the dentist is shouting out whilst they’re probing at your gums. They’ll be numbers between 0 and 4, and sometimes you’ll have a star thrown in for good measure.
Here’s what those numbers mean.
Imagine building a house. You’ve built your dream home, 4 bed, 2 bath, a nice dining room and living room and a beautiful kitchen with an island in the middle. Lovely. But you forgot one important thing before you started building… the foundations. You didn’t lay any! So now, your beautiful new house has started cracking, it’s sinking, you’ve got a flooded kitchen, and you can’t even open the door to that beautiful new living room.
Well, this is how your gums are to your teeth. You can have the healtiest teeth in the world, but without proper support from your gums and bone, then they’re going to go to waste and possibly fall out.
This is why we always nag about flossing!
It’s not to get on your nerves, it’s to make sure the foundations that are holding your teeth in place are solid, and that you get to keep your beautiful teeth forever.
Let me show you.
During your check up, we carry out a Basic Periodontal Examination, or a BPE. The probe that we use allows us to see how much gum and bone you’ve lost around your teeth. A score of 0 means you have superbly healthy gums and haven’t lost any bone. A score or 4 means you’ve got unhealthy gums and have lost a great deal of bone. Without bone, your teeth will likely fall out. And if you get a star, well, unfortonuately it’s not like school. A star means there is furcation present, which means we can get the probe between the roots of the tooth, which isn’t a good thing.
Picture 1 shows a healthy level of bone and gum. The tooth is secure and won’t be at all mobile.
Picture 2 shows gingivitis. This is the inflammation of the gum due to plaque and tartar being present around the tooth. This harbours bacteria, and inflames the gum. This is why we ask you to come in for regular scales to remove any deposits, and why flossing is important. You may find that your gums bleed when brushing at this point, but gum disease is very treatable and preventable
Picture 3 shows periodontal disease. This is when the periodontal ligaments and bone around the tooth have started to be eaten away by the bacteria that has been irritating the gum. The gum has started to fall away from the tooth creating pockets for more bacteria to get stuck in. Once you start losing bone, there is no way to get it back. The foundations around the tooth are starting to fail, and you will find your teeth are becoming more mobile.
Picture 4 shows advanced periodontitis. This is when severe bone loss has occured, and the gum has fallen completely away from the tooth root, exposing it. At this point, there’s not much we can do except remove the tooth, as it will be very mobile by now. The bone between the roots has also started to deplete, which is almost impossible to clean between, and will attract and trap food.
Here’s a good example of advanced periodontitis.
As you can see, there are big gaps between the teeth where bone and gum used to be, and the roots are exposed on almost every tooth.
But there is a way to stop this from happening. It’s a very slow process, the onset of gum disease. Most adults have a BPE score of between 0 and 2, and we can usually do something about that, but it involves help at home.